The Good, the Bad, and the Ugly

Working hand in hand with a good physician makes our lives easier and our jobs enjoyable. I am in no way trying to bash all physicians. And for the record, I bet they could write a book about all the crazy/stupid stuff we say to them. But that’s their story. This is mine 😃 …and a few physicians give me such great material to work with, it’s a shame not to share it 😃

My first day as a labor nurse, I went home and cried. I told my husband that I didn’t think I could do it. There was so much charting, we had so much autonomy, and I wasn’t sure if I liked not knowing (not knowing if the baby would respond to interventions after a decal, not knowing for sure if the baby was going to be vigorous after delivery, not knowing when the next patient was going to walk through the door). After I cried, I tried to tell him every cool/scary/gross thing that had happened to me that day. He was sooo not interested. It was like he heard what I was saying, but he didn’t get it. I kept saying “but the baby could have died if we wouldn’t have done this. Or been brain damaged. If my preceptor hadn’t been paying attention to her vital signs, she could have seized.” And he nodded, and he said that was horrible, but he just didn’t get it. I went to bed thinking about how much my preceptor and I had influenced someone’s care, being at the bedside. And the next day I went to work and was hooked.

Me.

My husband.

Sometimes we work with people who are even newer than we are. I remember one time I was in a delivery with a resident, and they cut the umbilical cord without clamping it. It started spraying blood like a water hose, whipping angrily around the air. Without even thinking, I grabbed it with my bare hands to clamp it off and said “oh FFS” 😃 I remember having to stand on a chair to wipe blood from a light fixture that day. The first (and only time) I had my back towards a patient in a delivery, I turned around just in time to see the resident catch the baby and let it slip right through his fingers into the trash bag. I GASPED SO LOUD :oops: I was sooooo thankful that the trash bag was full of soft stuff that caught the baby, and that the baby didn’t hit the floor. That was the first and last time I labeled stickers for the cord blood instead of staying right next to the patient’s leg 😃 I guess we all learned something that day!

Most nurses work 12 hour shifts. We come to work before our kids are up for school and come home just in time to give them a bath. We have patient’s that are poor, patient’s that make poor choices, patient’s that are super wealthy and super high maintenance, patient’s that don’t ask for anything and patient’s that ask for everything. Some patient’s are just like us, some patient’s are nothing like us, some patient’s are amazing and some are just weird. We have physician’s that like things this way and physician’s that like things that way and physician’s that change their mind about what they like every other day. We try to remember to chart everything, we try to remember to tell anyone who counts anything important, and we try to please our patients, their families, and our bosses. We’re like jugglers!

Sometimes we work with people who are just jerks. Nurses have to walk a fine line when advocating for the patient. Even when we can’t stand the physician, we don’t want the patient to mistrust the doctor that she goes to for care, the doctor she’s seen for her entire pregnancy. So we tell every patient that they have our favorite physician, and they have the best doctor around. And we can whole-heartedly say that about any physician with a straight face. I have heard of physicians who tell every single one of their patients that they had CPD or that their baby is breech so they can do a C-section. I have heard of physicians who gave every single patient having a vaginal delivery a 4th degree episiotomy. Literally. Every single one. It became like a game…how late could we call them to the delivery so that they wouldn’t have a chance to grab the scissors. Sometimes we’d hide the lidocaine and just pray that the baby would be delivered by the time more was brought to the room. More than once they were called so late they missed the delivery. But I was just glad no one had to get a Gelpi :/

Sometimes we work with people who just don’t like OB. I once had an anesthesiologist tell me that he wouldn’t do an epidural because the patient had a UTI :roll: When I questioned this (her WBC was below 10, she never had a fever, she wasn’t complaining of symptoms) he asked if I had gone to medical school and he just didn’t know it 😃 I didn’t even hesitate, I asked him if he was trying to intimidate me into not asking him questions. After he “consulted with a colleague” he ended up doing the epidural. Before every epidural he gave, he would tell the patient not to expect too much pain relief. lol I always wanted to tell him “if you don’t like OB, go to another unit. Because our patients think anesthesiologist are GODS.”

Sometimes we work with people who are just gross. A physician once rode his bike to work and then talked about his “sweaty peaches” for an hour. Gag. For the rest of the day I thought I was going to throw up in my mouth. But I think because we’re all looking at vaginas all day, and we all know how people got into this position in the first place, we don’t have many boundaries. But on what other unit would people talk about their body parts?!? What other unit would that even kind of be okay?! One time a doctor did a hysterectomy, and then he sat down and detailed a book he once read about an OB who tightened a woman’s vagina after a hysterectomy and then married her so he could sample his work. Seriously. GROSS.

Nursing is such a powerful, magical profession. We all know how to juggle, and we can all walk a fine line like an acrobat. We’re a little like waitresses, a little like hostesses, and a little like magicians. We have such a massive impact on the care a patient receives. We’ve all seen people grow. We see bad physicians come and bad physicians go. We see patient after patient after patient. Thank God for the good physicians and good colleagues we work next to, or else this job would be impossible to handle, emotionally or physically. I was happy when the lidocaine was brought to the room 30 seconds too late, and the patient delivered intact. But I was even happier when nurses were empowered to voice their concerns, and their concerns were taken seriously. I’m glad I came into nursing when there was that shift, and it wasn’t just a doctor’s world that nurses were living in. Nurse’s now have a seat at the head of the table. What are we going to do with that? 😃

p.s. now, most nurses on the unit don’t even know where the Gelpi’s are kept! 😃

I recall the first time I had to “get the Gelpis.” And 4-5 packs of various sutures. Bleh! Hated those things. And we had to wash and autoclave the instrucments. Those things are from the devil! Gwen had that “one” physician who always seemed to need them.